Clone of The Rotary Route South County Rotary Clubs | Benefiting Non-Profit Grant Application

Benefiting Non-Profit Grant Application

To apply to be a partial recipient of the funds raised by the Rotary Route | Paving the Way to Mental Wellness in South Orange County. Please provide details of your organizations's mission and non-profit business.
Organization Name

Non-Profit Business Name501c3 Tax ID
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name

Contact NameContact Title
E-mail
example@example.com
Main Contact Phone Number
Website
When was your non-profit business established?
What is the mission of your organization?
How many Adults ( Over 18) do you serve annually?
How many Children ( Under 18) do you serve annually?
Do you serve Active Military or Veterans?
Tell us about your programs:
What is your annual budget?
What is your % of annual board giving?

Number of Board Members% of Giving
As representative of your organization, if you had one thing in this world you would like to change, what would it be and how would you do it?
Authorized Signer

NameTitle
Signature
Signature Date

MonthDayYear
Today's Date
Should be Empty: